Dissection of the lymph nodes along the recurrent laryngeal nerve in robotic esophagectomy

Abstract

Lymph node (LN) metastasis serves as a pivotal prognostic determinant in esophageal cancer, particularly in cases of squamous cell carcinoma (SqCC). The involvement of LN metastasis frequently extends to the LNs along the recurrent laryngeal nerve (RLN). Radical dissection of these nodes is imperative for precise staging and the prevention of loco-regional recurrence. Historically, the emphasis on RLN node dissection has been evident in numerous literature, establishing it as a mandatory procedure in different countries. Nevertheless, the risk of RLN palsy following such dissection is a substantial concern, given its association with significant postoperative complications and long-term implications for quality of life. Recent literature has highlighted RLN node dissection in robotic surgery, demonstrating favorable outcomes in comparison to alternative surgical modalities. This review paper aims to comprehensively assess prior publications on this subject, elucidating the outcomes and implications of RLN node dissection in robotic esophagectomy (RE).